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SOUTH SHORE SPORTS & MUSCULAR NPI 1104822576


NPI Information

NPI: 1104822576
Provider Name: SOUTH SHORE SPORTS & MUSCULAR
Classification: Physical Therapist - 2251X0800X
Entity Type: Organization

Specialization: Orthopedic

CLIA Number: 22D0079457

Address:
90 LIBBEY INDUSTRIAL PKWY
STE 103
EAST WEYMOUTH, MA
ZIP 02189
Phone: (781) 331-9600
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SOUTH SHORE SPORTS & MUSCULAR is an orthopedic physical therapist in East Weymouth, MA. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice. SOUTH SHORE SPORTS & MUSCULAR NPI is 1104822576. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

90 LIBBEY INDUSTRIAL PKWY
STE 103
EAST WEYMOUTH, MA
ZIP 02189-129
Phone: (781) 331-9600
Fax: (781) 335-1556

The provider's authorized official is Stephen Lally Newcomb .
The authorized official title is General Manager and has the following contact phone number (781) 331-9600.

The CLIA number assigned to this NPI record is 22D0079457 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/22/2005 and was last updated on 12/19/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12251X0800XPhysical TherapistOrthopedic5290MASSACHUSETTSYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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